HomeMy WebLinkAbout182014 02/03/2010 CITY OF CARMEL, INDIANA VENDOR: 362749 Page 1 of 1
1 ONE CIVIC SQUARE KELSEY MILLER
I CARMEL, INDIANA 46032 13259 EASTWOOD LN CHECK AMOUNT: $66.88
FISHERS IN 46038
CHECK NUMBER: 182014
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 66.88 TRAVEL FEES EXPENSE
PRESCRIBED BY STATE BOARD OF ACCOUNTS v OA I
GENERAL FOBBING. 101 (IBM C N J MILEAGE CLAIM J U V
TO
(GOB A I
ON ACCOUNT OF APPROPRIATION NO. FOR
(OFFICE, BOARD, OR INSTITUTION)
D FROM TO I S AEADI PF G AUTO MILEAGE
1 POINT I POINT START FINISH NATURE OF BUSINESS TRAVE E0 5
PER MILE
5 4
AUTO LICENSE NO. TOTALS
0' 1
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is le ally due, after aliowing all just credits
end that no art of the same has been paid. �l./ n n 9 /T
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Date part O L U I l �/�!/t d I V ,'Lic
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PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. lel 119867
MILEAGE CLAIM )0' S al n (l 1
C (GOVERNMENTAL U14111 1
ON ACCOUNT OF APPROPRIATION NO. FOR
OFFICE, HOARD, DEPARTS@fr OR INSTOUTION)
DATE FROM TO II SPEEDOMET
IN AUTO MILEAGE
2 POINT POINT START MEM NATURE OF BUSINESS TR a 7 r
I
PER MILE
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5. 1 l
AUTO LICENSE O. TOTALS I ii N 1 J
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. 4 1 "Y11^^^
V
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, I hereby certify that the foregoing account is just and correct, that the amount claimed is 1- ly due, after aliowing all t cr- s
end that no part of the same has been paid.
1
Date �O iif.
1 /L
1 08)-6 o r 7 5
s L 3 0,q
iiviocou i 1 JAN 072010 i4
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
362749 Miller, Kelsey Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1/6/10 Reimb. Mileage 10/21 12/16/09 66.88
Total 66.88
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
Voucher No. Warrant No.
362749 Miller, Kelsey Allowed 20
In Sum of
66.88
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
1081 Reimb. 4343000 66.88 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
28 -Jan 2010
A% Al1i22-
i
Signature
66.88 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund